Objective: The purpose of this study was to determine the most effective product (power drink, fruit-flavored glucose drink, or water) for maintaining fluid and electrolyte balance and blood sugar levels in individuals wearing mission-oriented protective postures (MOPP) gear. Biochemical warfare is a constant threat and, accordingly, personnel have to don MOPP gear, which greatly intensifies the incidence of dehydration and its subsequent problems such as thermal injuries. With the exception of combat causalities, dehydration is the military?s number one health problem during war. It is also of paramount importance during peacetime training exercises because loss of fluids and electrolyte imbalances can lead to thermal injuries such as heat cramps, heat exhaustion, heat stroke, and death. These problems can seriously compromise the mission readiness of the United States military in accomplishing goals, and due to the changing nature of homeland defense, it is anticipated that many civilian health care and community service workers (firefighters and police) will need to begin training in similar types of protective gear.
Design: The study incorporated an experimental, pretest/posttest crossover design.
Population, Sample, Setting, and Years: Because there are differences in men and women with respect to total body water, lean, and fat mass, the study used two separate samples of men (N=45) and women (N=45) ranging from 18 to 52 years of age. In addition, the study examined the effects of the treatment modalities on a sample of men who had a body fat < 18 % and > 19 % and a sample of women who have a body fat < 26% and > 27%. Data were collected in the summer of 1999 in San Antonio, Texas.
Intervention and Outcome Variables: Initially, the intervention involved the provision of three different types of fluids for hydration during training. Laboratory tests (serum sodium, osmolality, potassium, glucose, urine osmolality, total body water), percentage of body fat, temperature, blood pressure, pulse, and weight represented outcome variable data that were collected.
Methods: Subjects were enrolled in the study after informed consent was obtained and then randomly assigned to one of three fluid groups. The next day they were randomly assigned to one of the other fluids, and on the third day they were assigned to the remaining fluid group. The subjects walked 4.8 miles and attended outside briefings for five hours in MOPP gear. After each treatment, the same data were collected with the exception of percentage of fat. An initial pilot study of 20 subjects was implemented prior to conducting the larger study. Eight subjects could not tolerate the fruit-flavored drink in the quantity required for the study. After implementation of the study, an additional two could not tolerate the fruit-flavored drink. A total of ten individuals had nausea and three vomited after consuming the fruit-flavored fluid. The fruit-flavored drink was therefore eliminated from the study.
Findings: MANOVA and post hoc (Tukey) statistical analyses revealed that the ?power drink? group, when compared to the water group, had statistically significantly higher post-test serum glucose (F=7.8, p=0.006) and sodium (F=13, p=0.001) levels, but no significant differences in serum osmolality (F=2, p=0.137), potassium (F=0.10, p=0.744), total body water (F=0.14, p=0.707), or urine osmolality (F=0.18, p=0.669). There were also no significant differences in changes in blood pressure (F=0.165, p=0.686), temperature (F=3, p=0.072), pulse (F=0.5, p=0.458), or weight (F=1, p=0.312). When comparing men who had a body fat < 18 % (N=19) and > 19 % (N=26) with a sample of women who had a body fat < 26% (N=14) and > 27% (N=31), there were no significant differences in any parameter (p=> 0.05) or differences between the genders (p=0.235). Perception of fatigue was significantly less (p=0.05), ease of drinking was significantly less (p=0.03), and exertion was significantly less (p=0.005) in the ?power drink? group compared to the water group.
Conclusions: Water is as effective as a power drink in maintaining fluid and electrolytes in individuals while wearing MOPP gear and exercising. If individuals are not eating, a power drink maintains blood sugar.
Implications: Fluid and electrolytes can be maintained with water during MOPP training; however, perceptions of fatigue, exertion, and ease of drinking were less with the power drink probably because the blood sugar was maintained with this group.
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